ADVOCATING FOR PERSON – AND RELATIONSHIP

-CENTERED PRACTICES

“I am Richard who seeks to live a purposeful and purpose

filled life up to and through my last breath.”

 

~ Richard Taylor, PhD, who lived the last ten years of his

purpose filled life with Alzheimer’s dementia

 

Person-centered practices are deemed the gold standard globally (Institute on Medicine, 2001; World Health Organization, 2007). The roots of person-centeredness originate in the foundational work of Carl Rogers (1949) and his approach to client-centered psychotherapy. Tom Kitwood (1997) applied the person-centered philosophy specifically to dementia stipulating that individuals living with dementia have an enduring sense of self, and maintain feelings, preferences and personality characteristics until the end of life. 

 

The dominant perception of dementia focuses on cognitive losses and functional impairments rather than a proactive approach based on understanding individual symptoms and identifying strengths for accommodations and strategies to support changing abilities.

Person-centered practices enhance well-being and move away from a limiting medical framework to a broader framework that integrates all aspects of being human (physical, social, emotional, and spiritual).

The international Organisation for Economic Co-operation and Development determined that dementia receives the worst quality of care in the developed world (2015).  Largely this is because dementia is a condition widely misunderstood and stigmatized. Because of the detriments these have to the well-being of individuals and families living with dementia, DAA strongly advocates for adoption of what we call ‘person- and relationship-centered practices’ in all care settings (e.g., home, assisted living, nursing homes, adult day, home care, hospitals, primary care, hospice, and rehab).  Person- and relationship-centered principles go a step beyond person-centered in recognizing that relationships are foundational.  

HOW DAA IS ADDRESSING ADVOCATING FOR PERSON- AND RELATIONSHIP-CENTERED PRACTICES

DAA partnered with The Eden Alternative in a multi-year effort to collaboratively frame and develop widely accepted standards for person- and relationship-centered dementia support practices to move beyond practices that are an ideal to practices that become the standard.  This project, Raising the Bar: Creating a Better Society in Which to Live With Dementia, worked with individuals and care partners living with dementia as well as a broad and diverse group of interdisciplinary specialists to ensure the project was well informed. 

Raising the Bar: A Practice Guide for Assisted Living Communities will be launched in August 2020.  For additional information,  please contact Karen Love at karenlove4@verizon.net.

REFERENCES

Institute on Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

Kitwood, T. (1997). Dementia reconsidered: The person comes first. Maidenhead: Open University Press.

Organisation for Economic Co-operation and Development (2015). Addressing dementia: The OECD response. Paris: OECD.

Rogers, C. (1949). The attitude and orientation of the counselor in client-centered therapy. Journal of Consulting Psychology, 13(2): 82-94.

World Health Organization (2007). WHO global strategy on people-centred and integrated health serviced: Interim report. Geneva, Switzerland: World Health Organization.

RESOURCES

Dementia Action Alliance (2016). Living with Dementia: Changing the status quo. Falls Church, VA: Dementia Action Alliance.

Manthorpe, J., and Samsi, K. (2016). Person-centered dementia care: Current perspectives. Clinical Interventions in Aging, 11: 1733-40.

Power, G.A. (2014). Dementia beyond disease. Baltimore, MD: Health Professions Press.

Swaffer, K. (2016). What the hell happened to my brain? London, England: Jessica Kingsley Publishers.

Wilberforce, M., Challis, D., Davies, L., et. al. (2017). Person-centredness in the community care of older people: A literature-based concept synthesis. International Journal of Social Welfare, 26: 86-98.